Rules in Progress

Rule making is the process the Department of Health uses when proposing to create, change, or delete rules in order to protect public health. To learn more, see the department’s “What is Rule Making?” webpage.

To get updates about rule-making projects and other topics, select "Subscribe for Updates" at the bottom of the page.

Current rules in progress

Hospital Emergency Services

On May 12, 2025, the department filed an emergency rule (PDF) continuing the provision of emergency rules initially adopted (PDF) by the department on January 13, 2025, under WSR 25-03-056, that incorporated the federal Emergency Medical Treatment and Labor Act (EMTALA) into state law, with modifications. This rule rescinds other provisions of the previously adopted emergency rule because substantively identical provisions were codified in the recently enacted Engrossed Substitute Senate Bill (ESSB) 5557 (PDF). These provisions include those revising the definition of “Emergency medical condition” in RCW 70.41.020, imposing requirements related to hospital transfers, and imposing requirements related to emergency medical care for pregnant persons. The emergency rules will continue while permanent rulemaking is in progress.

On May 28, 2025, the department filed a CR-101 to begin rulemaking to incorporate ESSB 5557 and consider other amendments to the requirements for hospital emergency services currently found in WAC 246-320-010 and 246-320-281 and other related rules. Permanent rulemaking workshops will be held online and you can register to attend at the links below.

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Hospital at Home

The department filed a CR103 (PDF) on May 30, 2025, adopting rules that establish operating standards and an application process for hospital at-home programs by creating WAC 246-320-278, and amending WAC 246-320-199 to establish a one-time application fee that is necessary to cover the cost of reviewing hospital at-home applications. The rules become effective on October 1, 2025, and hospitals licensed under chapter 70.41 RCW will need to submit an application to the department to operate the program. Application information will be available August 2025.

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Acute Care and Psychiatric hospitals - Fees

On June 25, 2024, at 11 a.m., the Department of Health held a public rule hearing related to initial and annual licensing fees for hospitals to generate the revenue needed to license, perform inspections and investigations, and complete other regulatory work required to protect patient safety. The CR-102 for Acute Care and Psychiatric Hospital Fees was filed on May 21, 2024, as WSR 24-11-118 (PDF) to propose amendments to WACs 246-320-199 and 246-322-990.

The Department of Health is adopting amendments to WAC 246-320-199 and 246-322-990 to update fees for acute care hospitals licensed under chapter 246-320 WAC and private psychiatric hospitals licensed under chapter 246-322 WAC.

These changes address funding needs and to clarify and standardize the language.

To comply with this direction, the Department of Health has issued CR-103P (PDF) and an accompanying concise explanatory statement (PDF) to highlight the necessity for the updated fees. These updates are intended to ensure adequate funding for hospital inspections, investigation, and licensing programs to protect patients.

For additional information, see our hospitals webpage or fees webpage or email the facilities program. 

Supporting Materials:

Acute Care hospitals – 23-hour crisis relief centers

The Department is considering amending the Acute Care Hospital regulations in chapter 246-320 WAC to implement Second Substitute Senate Bill 2SSB 5120 (PDF) relating to 23-hour crisis relief centers, a new type of facility that will provide mental health and substance use crisis response to adults.

CR-101(PDF) - Amending the Acute Care Hospital regulations in chapter 246-320 WAC to establish rules prohibiting hospitals licensed under 70.41 RCW from discharging or transferring a patient to a 23-hour crisis relief center unless the hospital has a formal relationship with the 23-hour crisis relief center.

Updating references to pharmacy rules within WAC chapters for hospitals, ambulatory surgical facilities, in-home services agencies, and residential treatment facilities

The Department of Health has filed a CR-103 (PDF) to correct an error related to the previous fee increase pertaining to the renewal fee amount. 

This rule will go into effect on July 15, 2025.